Advanced Search

Primary Care Coding Alert

Reader Questions:

Coding for Gyn and Pap Smear Depends on Circumstances and Payer

Published on Wed Aug 04, 2010

Question: What procedure codes should we submit for a gynecology exam and Pap smear?Montana SubscriberAnswer: From a CPT perspective, you do not have a code choice specific to a gynecology exam and collection of a Pap smear specimen. If the exam and specimen collection are problemoriented (i.e., the patient has presented with a chief complaint leading to the exam), then the exam and specimen collection are simply part of the E/M service otherwise reported for the encounter (i.e., 99201-99215, Office or outpatient visit . . .).More typically, a gynecology exam and Pap smear collection are considered a "well-woman exam." In this situation, they should be considered part of and reported with the appropriate preventive medicine visit service (such as 99395, Periodic comprehensive preventive medicine reevaluation and management of an individual . . . ; 18-39 years), since preventive medicine visits include an age and gender appropriate history and exam.Some payers [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Primary Care Coding Alert

View All